‘The wave is coming up upon us’: Critical care doctors already feeling effects of COVID surge

Published 7:01 am Saturday, November 7, 2020

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By Catharine Richert

COVID-19’s relentless ascent statewide is beginning to take its toll on Minnesotans’ access to hospital care — and doctors are sounding the alarm.

One ER doctor at a small hospital in northern Minnesota tells a story of struggling to find a bed for a patient who needed an emergency procedure the hospital wasn’t able to perform.

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“She was very sick. She needed an emergent procedure down in the [Twin] Cities or anywhere,” he said.

For smaller hospitals, that’s not an uncommon situation. They have agreements in place that allow them to transfer patients to hospitals that are better equipped to handle more acute care.

“It was an overnight shift I was working. Two in the morning and not a single hospital system had a bed” where the patient could get the care she needed, said the doctor, who didn’t want to publish his name because he wasn’t authorized by his employer to speak with the media. “We called everywhere. I called 10 different hospitals.”

Finally, hours later, he said, they found a bed. But the doctor said he’s worried the patient didn’t make it, though he doesn’t know for sure.

“There was a huge time delay,” he said. “She needed this procedure, and there were no beds.”

That was three weeks ago. Until recently, the doctor said, he hasn’t run into much trouble trying to find a place to transfer patients who urgently need care.

That night in the ER was his first inkling that, after months of hospitals around the state being able to manage their capacity during the coronavirus pandemic, things were about to shift — for the worse.

He’s among six physicians working on the front lines of COVID-19 care across Minnesota who described to MPR News this week a looming tipping point in the state’s ability to manage hospital capacity as COVID-19 cases make their grim climb upward. Some didn’t want to be named publicly because they didn’t have permission from their employers to speak with the media.

They all described a similar scene: Patients waiting hours and hours in the emergency room before being admitted to a hospital bed. Doctors having a harder and harder time finding free space at other hospitals when patients need to be transferred. And patients who are transferred being moved to hospitals hours away from where they live.

Behind the scenes, hospitals are engaged in a complicated game of chess, moving staff, beds and other resources from one to another to accommodate a growing patient volume that they say is the result of multiple factors at once.

Rapidly rising COVID-19 case counts statewide have meant that more people are being admitted to the hospital to be treated for the virus, and those patients are typically staying longer than other patients.

But at the same time, hospitals are trying to make up financial ground through surgeries and other procedures after they halted noncritical care in the spring when the pandemic first came to Minnesota. And many patients who had delayed care in the early days of the pandemic are now catching up on care they urgently need.

As coronavirus cases continue their record-breaking rise, doctors say continuing to move patients and staff around to meet the needs of a growing volume of patients is a strategy that will work only so long before the state will have to quickly stand up new beds and extra space. And even then, they worry there won’t be enough doctors, nurses and other health care professionals to staff those additional beds.

“The big fear is that we’re going to get to the situation that New York and Italy were in in the spring, and it’s a total disaster,” the emergency room doctor said. “We’re worried. We’re all really worried.”